Document Detail


Stereotactic puncture and lysis of spontaneous intracerebral hemorrhage using recombinant tissue-plasminogen activator.
MedLine Citation:
PMID:  7731513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have tested a treatment protocol for intracerebral hemorrhage (ICH), consisting of stereotactic insertion of a catheter into the clot, hematoma lysis by the injection of a fibrinolytic agent, recombinant tissue-plasminogen activator (rt-PA), and closed system drainage of the liquefied clot. Fourteen patients underwent computed tomographically guided stereotactic hematoma puncture and silicone tube insertion within 72 hours of intracerebral hemorrhage. The majority (nine patients) suffered from ganglionic ICH, and the size of the hematoma ranged between 3 x 3 x 4 cm and 7 x 7 x 4 cm (mean, 5.2 x 4 x 3.6 cm). All patients had major neurological deficits with or without an impaired level of consciousness, but without signs of transtentorial herniation. The initial, then daily, dose (in milligrams) of rt-PA administered via the silicone tube equalled the maximal diameter (in centimeters) of the original and remaining clot as measured initially, then daily, by computed tomographic scan. The number of rt-PA injections was four in one patient, three in eight patients, two in four patients, and one in one patient, and the total dose of rt-PA required ranged from 5 to 16 mg (mean, 9.9 mg). After rt-PA injection, the tubing was clamped for 2 hours and then opened to drain spontaneously through a closed system against 0 cm of pressure. At follow-up 6.6 months (mean) after treatment (ranging from 3 to 13 months) and according to the Glasgow outcome score, one patient was Grade V, four were Grade IV, five were Grade III, two were Grade II, and two had died.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
C Schaller; V Rohde; B Meyer; W Hassler
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  36     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-05-30     Completed Date:  1995-05-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  328-33; discussion 333-5     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Klinikum Kalkweg, Duisburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cerebral Hemorrhage / radiography,  surgery*,  therapy*
Female
Follow-Up Studies
Hematoma / surgery
Humans
Male
Middle Aged
Punctures*
Recombinant Proteins
Stereotaxic Techniques*
Suction
Thrombolytic Therapy*
Tissue Plasminogen Activator / therapeutic use*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Recombinant Proteins; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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